Control and Prevention of Zoonotic Epidemics in Cities: A Socio-Spatial Approach

项目摘要 由于人畜共患疾病之间复杂的相互作用，对公共卫生构成了独特的挑战 人类、动物、病原体和环境。城市化、移民和城市景观增加了 对这些相互作用以及人畜共患病病原体的控制和预防增加了复杂性 需要创新的多学科方法方法，考虑到社会、空间和 城市地区的人口动态。 人畜共患病原体的流行正在拉丁美洲的主要城市中心和 在世界范围内，其中秘鲁的阿雷基帕市正处于犬类狂犬病疫情之中。司机们 这一流行病在多个层面的工作：个人和社区层面的因素，包括社会决定因素， 这可能解释了目前家畜狂犬病疫苗接种率较低的原因。城市地理学也可以 影响参与人畜共患疾病控制方案，促进犬只狂犬病的出现和 使它的控制变得复杂。自由漫游的主人和流浪狗及其独特的生态和种群 动态也会影响控制活动的结果。在这份提案中，我将开发一种新的方法 结合数学和社会方法的城市人畜共患疾病的控制和预防， 使用狂犬病作为人畜共患疾病的模型，这是由城市动态强烈决定的。 15年后，随着城市的重新崛起，卫生部未能平息狂犬病 在阿雷基帕复杂的城市环境中流行。我猜想失败主要是由于三个原因 因素：1)对犬类疫苗接种的决定因素知之甚少；2)忽视了 未接种疫苗的狗，特别是流浪狗；以及，3)城市中疫苗帐篷的位置不佳 风景。 在第一个目标下，建议进行定性研究和调查，以确定社会和空间 城市环境下犬类疫苗接种的决定因素。第二个目标是用数学方法进行评估 考虑流浪狗在狂犬病控制项目中的作用的不同策略。最后，第三个目标将 将社会和空间因素纳入数学算法，优化疫苗帐篷的位置。 在这第三项研究中，将进行离散选择实验，以测试优化方案的可接受性 疫苗摊位。 该提案旨在为#年的人畜共患疾病控制规划提供一种迫切需要的新方法。 城市整合城市景观、健康行为、多样化人口和健康最佳配置 服务设施。

Project Summary Zoonotic diseases present unique challenges for public health due to the complex interactions between humans, animals, pathogens, and the environment. Urbanization, migration, and the urban landscape add additional layers of complexity to these interactions, and the control and prevention of zoonotic pathogens requires innovative multidisciplinary methodological approaches that take into account social, spatial and population dynamics in urban areas. Epidemics of zoonotic pathogens are ongoing in major urban centers across Latin America and worldwide, and among them, the city of Arequipa, Peru is in the midst of a canine rabies epidemic. The drivers of this epidemic work at many levels: Individual- and community-level factors, including social determinants, may explain the currently low vaccination rate of domestic animals against rabies. Urban geography can also affect participation in zoonotic disease control programs, facilitating the emergence of canine rabies and complicating its control. Free-roaming owned and stray dogs with their unique ecology and population dynamics could also impact the results of control activities. In this proposal I will develop a new approach for the control and prevention of zoonotic disease in cities that integrates mathematical and social approaches, using rabies as a model zoonotic disease strongly determined by urban dynamics. Following the urban re-emergence after 15 years, the Ministry of Health has failed to quell the rabies epidemic in Arequipa's complex urban environment. I hypothesize that the failure is due primarily to three factors: 1) Poorly understood determinants of canine vaccination uptake; 2) Ignored spatial heterogeneity of unvaccinated dogs, especially stray dogs; and, 3) Suboptimal placement of vaccine tents across the urban landscape. Under a first aim, a qualitative study and a survey are proposed to identify social and spatial determinants of canine vaccination uptake in urban settings. The second aim will evaluate mathematically different strategies that consider the role of stray dogs in rabies control programs. Finally, the third aim will incorporate social and spatial factors into a mathematical algorithm to optimize the location of vaccine tents. For this third study, a discrete-choice experiment will be performed to test the acceptability of the optimized vaccine stand placements. This proposal aims to produce an urgently needed novel approach for zoonotic disease control programs in cities to integrate urban landscapes, health behaviors, diverse populations, and optimal placement of health service facilities.